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Last week I was interviewed on BBC radio about Channel 4’s new show ‘The Hoarder Next Door’. In previous blogs, I have briefly examined pathological hoarding and one particular type of hoarding behaviour (i.e., pathological book hoarding). Another very specific type of hoarding is animal hoarding (typically defined as having a higher number of pets than is normal to have and failing to look after them properly). In a 2006 issue of Veterinary Medicine, Dr Gary Patronek (Tufts University, US) defined animal hoarding as: “Pathological human behaviour that involves a compulsive need to obtain and control animals, coupled with a failure to recognize their suffering”. According to a recent literature review led by Dr Albert Pertusa (Institute of Psychiatry, London), this sub-type of hoarding has been defined as the accumulation of a large number of animals along with a:

Failure to act on the deteriorating condition of the animals (including disease, starvation or death) and the environment (severe overcrowding, extremely unsanitary conditions)

Lack of awareness of the negative effects of the collection on their own health and wellbeing and on that of other family members.

Animal hoarders often live in severe domestic squalor and live in more unsanitary conditions than other types of hoarder (although some other types of disorder such as Diogenes Syndrome – also known as ‘senile squalor syndrome’ – is characterized by extreme self-neglect, apathy, domestic squalor, social withdrawal, compulsive hoarding of rubbish, and lack of shame). It is common for the houses of animal hoarders to be filled with animal faecal waste, and it is not unusual to find the decomposing remains of dead animals. The animals are often left to reproduce at will as animal hoarders do not typically get their pets spayed or neutered. Sick animals are typically left to die and rot. A 2009 study by Dr Gary Patronek and Jane Nathanson examined the living areas of 49 animal hoarders. They reported that four out of five living areas were “heavily littered with trash and garbage” (78%), and that in just under a half there was “profuse urine or feces in the living spaces” (45%).

One very key difference between animal and non-animal hoarders is that animal hoarding may involve animal cruelty. Dr Frank Ascione (Utah State University) defines animal cruelty as a “socially unacceptable behavior that intentionally causes unnecessary pain, suffering, or distress to and/or death of an animal”. Ascione believes that animal neglect falls within this definition and that therefore animal hoarders are guilty of animal cruelty. However, some researchers claim that the animal cruelty is not deliberate as the compulsive hoarding is underpinned by some kind of mental disorder.

Many animal hoarders are known to hoard other items and objects, and therefore some experts in the area (such as Patronek and Nathanson) suggest that animal hoarding is a special manifestation of compulsive hoarding. There is also some research that suggests that animal hoarding follows more ‘conventional’ hoarding. However, animal hoarders share many of the same characteristics as those with Diogenes Syndrome. It has also been suggested that animal hoarders had very controlling parents, come from backgrounds that were chaotic and/or deprived in childhood (and sometimes described as scary and frightening), have psychological issues and problems surrounding emotional attachments, and often attribute human characteristics to the animals they own. Another seemingly common theme is that of physical and/or psychological loss. For animal hoarders, losing a possession is for them like losing a close friend or family member. It has also been claimed that some animal hoarders are often incapable of looking after and caring for themselves (let alone animals – particularly if there are so many of them).

Colin Berry and colleagues, writing in an overview on animal hoarding for the journal Animal Law cited a 2002 review by Arnold Arluke and reported:

“Arnold Arluke analyzed one hundred articles about animal hoarding.Arluke suggests that, rather than presenting a realistic picture of animal hoarding that captures the complexity of the issue, the media presents animal hoarding in a stream of different emotional themes.While drawing the reader’s attention, these themes are more likely to elicit revulsion, sympathy, or humor from the reader rather than understanding of the hoarding issues themselves.Arluke concludes that these emotional themes ‘present an inconsistent picture of animal hoarding that can confuse readers about the nature and significance of this behavior.’Portraying hoarders’ stories in this light can cause the public to be sympathetic and even supportive of the hoarder and her actions.Some hoarders even receive donations or offers of more animals”.

In the same paper, Berry and colleagues also noted that in terms of demographics, empirical studies have found that animal hoarders are typically middle-aged or older females who are often disabled, retired, or unemployed, living alone in homes without working appliances. The animals that are most likely to be hoarded are cats (the highest number they came across being owned was 400) and dogs (the highest number owned being 218). They also noted that numerous psychological models have been proposed to explain animal hoarding, including focal delusion, addiction, obsessive-compulsive disorder (OCD), zoophilia, and dementia. Although there is no consensus, the conceptualizing of animal hoarding as a form of OCD appears to be the most popular explanation (although this does not appear to explain all cases). According to Karen Cassiday, no-one knows what the prevalence of animal hoarders is within any population although press reports over the last decade have quintupled. Whatever the prevalence, animal hoarding is an area that needs further investigation.

Ascione, F. (1993). Children who are cruel to animals: A review of research and implications for developmental psychopathology. Anthrozoos: A Multidisciplinary Journal of The Interactions of People & Animals, 6, 226-247.

Like many people, I save and collect various items (in my case, records and CDs). Collecting is a natural human activity and some evolutionary psychologists have argued that it may have had an evolutionary advantage in our past history (e.g., there may have been periods of severe deprivation where hoarding was adaptive and enhanced the probability of reproductive success and human survival). However, for a small minority, collecting and hoarding can become excessive and pathological as demonstrated a few months ago (December 2011), when Channel 4 broadcast a television programme on compulsive hoarders as part of the Cutting Edge series of documentaries

Compulsive hoarding – also known as pathological collecting in some scientific circles – is a behaviour typically characterized by the excessive acquisition and keeping of seemingly worthless objects that have little or no material value. According to a recent review led by Dr Albert Pertusa (Institute of Psychiatry, London), a widely accepted definition of compulsive hoarding is “the excessive collection and failure to discard objects of apparently little value, leading to clutter, distress, and disability” (p.371). The difficulty in discarding or letting go of the accumulated possessions is the critical criterion of pathological hoarding. It is also worth noting that some leading figures in the hoarding field don’t like the term ‘compulsive hoarding’ for many of the same reasons that those in the gambling studies field don’t like the term ‘compulsive gambling’.

There has been a substantial increase in research into the disorder in recent years. Interestingly, it appears to be inversely related to income (as it is far more common among the economically deprived). Based on empirical research, the prevalence of compulsive hoarding is thought to be around 2-5% among adult populations although there are certain socio-demographic groups where the prevalence is known to be higher (e.g., there is a higher prevalence among men and the elderly).

As with most behaviours that involve a compulsive element, there are associated physical health risks with compulsive hoarding. There are also reports that the behaviour can lead to detriments in other areas of the affected person’s life including impaired psychological functioning, financial difficulties, and the compromising of relationships with family and friends.

Given that excessive hoarding impacts on the physical living space of the individual and can take over in every room in an affected person’s home (such as people who never throw away a single newspaper or magazine), it can lead to a negatively detrimental effect on life’s essential activities such as personal hygiene and house sanitation – both of which may lead to increased health risks. Other activities such as sleeping and cooking food can also be seriously affected. Mobility in the person’s day-to-day living space may be affected and some hoarded items (such as newspapers and household waste) may lead to increased fire risks. It has also been noted that at a societal level, compulsive hoarding is a burden on public health in terms of poor physical health, occupational impairment, and the utilization of social services.

Although the collecting behaviour may be pathological, there is still a lot of scientific debate as to whether it is a stand alone disorder or symptomatic of other conditions, most notably obsessive-compulsive disorder [OCD] – particularly as approximately 20%-40% of people with OCD patients are known to have various hoarding compulsions and obsessions. Some researchers also suggest that other psychological traits such as perfectionism and indecisiveness may underpin some hoarding behaviour. Other co-morbidities are known to exist including alcoholism, in addition to paranoid, avoidant, and schizotypal traits. Compulsive hoarding also appears to be similar to impulse control disorders, particularly that of compulsive buying as many hoarders’ homes are full of bought items that are often unopened and still in their original packaging. Approximately three-quarters of hoarders also engage in excessive buying, and over half also accumulate items and possessions for free. Research has indicated that the condition of hoarders’ homes have been described as “merely cluttered” to “squalid”.

In fact, Dr Pertusa and his colleagues claim that the majority of hoarding studies are actually based on the assumption that the behaviour is a form of OCD. However, there is accumulating evidence that hoarding may be a separate entity to OCD. As is also pointed out by Pertusa and colleagues, there is no reference to hoarding behaviour in the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-IV) criteria for OCD. Furthermore, in relation to obsessive-compulsive personality disorder, hoarding is mentioned in only one of the eight diagnostic criteria.

A recent meta-analytic study led by Dr Michael Bloch (Yale School of Medicine, USA) examined 21 worldwide studies with over 5000 OCD individuals and concluded that hoarding is an independent factor in both in children and adults. The study also reported that unlike typical OCD sufferers, compulsive hoarders don’t experience intrusive thoughts about possessions urging them to perform ritualized behaviour. It has also been observed that around a third of compulsive hoarders don’t show any other OCD symptoms. Dr Bloch and colleagues conclude that compulsive hoarding is a more passive behaviour where intense distress is only triggered when the hoarders face the prospect of having to get rid of their accumulated possessions.

Although there are many published studies where compulsive hoarders are treated pharmacologically with serotonin reuptake inhibitors (that show very mixed results in relation to their effectiveness), the most effective treatment appears to be cognitive behavioural therapy (CBT). This typically involves hoarders learning (through cognitive restructuring and response prevention) how to deal with situations that cause intense anxiety. Research also suggests that some types of CBT are better than others. CBT approaches that focus on the hoarder’s motivation, acquisition of new items, and removal of items from the hoarder’s home appear to show the best outcome. Treatment studies also suggest that pathological hoarding may be best classified as a discrete disorder with its own diagnostic criteria rather than as a form of OCD.